Edoxaban May Be Effective for Treating Patients With Venous Thromboembolism

Edoxaban may be as effective as warfarin for the prevention of symptomatic recurrent venous thromboembolism (VTE).

The oral direct factor Xa inhibitor, edoxaban, may be as effective as warfarin for the prevention of symptomatic recurrent venous thromboembolism (VTE), with less clinically relevant bleeding, for patients with cancer, a study published in the journal The Lancet Haematology has shown.1

Investigators conducted a prespecified subgroup analysis and a post-hoc analysis of this Hokusai-VTE trial, a double-blind, double-dummy, multicenter study conducted between 2010 and 2012, for which 771 patients with cancer and acute symptomatic deep-vein thrombosis, or acute symptomatic pulmonary embolism, were recruited.

Patients were randomly assigned to receive edoxaban 60 mg once daily or warfarin for at least 3 months up to 12 months. All participants initially received enoxaparin or unfractionated heparin for at least 5 days.

Recurrent VTE occurred in 4% of the 378 patients who received edoxaban, compared with 7% of the 393 patients who received warfarin (hazard ratio [HR], 0.53; 95% CI, 0.28-1.00; P = .0007). Edoxaban was not non-inferior to warfarin.

The study demonstrated that 12% of patients who were given edoxaban experienced clinically relevant bleeding, versus 19% of those who received warfarin (HR, 0.64; 95% CI, 0.45-0.92; P = .017).

Survivorship plans for adolescent and young adult survivors need to consider the relative long-term survival for AYAs with certain cancers. Those with certain cancers may have excess long-term mortality.

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